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Tuesday, February 26, 2013

Please change Diet orders. Mediterranean diet

Each day I admit cardiac patients who end up with a "heart healthy diet".
It may change now!.

The definition of heart healthy diet is evolving as we speak. For a diet to be heart healthy I may have to order some nuts, fish, virgin oil with some red wine.

I hope I won't get into trouble.

A new study published in New England Journal of Medicine defies our conventional beliefs regarding low fat diet to be heart healthy. This new study suggest that Mediterranean diet is more "heart healthy" almost by 30% as compared to a regular diet.

In this humongous study out of Spain, where 7447 individuals were enlisted were shown to improve their heart attack risk by 30%.

Participants were asked to eat white meat like fish, lentils, almonds, walnut and virgin oil. Results are so phenomenal that some of the primary researchers even changed their own diet.

By the way today I bought some nuts on my way back!

PS: About the picture, very visual menu somewhere in Europe.

Friday, February 22, 2013

Buddhist temple, Kyoto, Japan

Keeping an eye on me.

Keeping an eye on me. by At_a_tangent
Keeping an eye on me., a photo by At_a_tangent on Flickr.

Bird One

_DSC0419 by At_a_tangent
_DSC0419, a photo by At_a_tangent on Flickr.

Yahoo Dome, Kyoto. HDR version

Huddle, Multidisciplinary Rounds.

Finally I was able to successfully roll out Huddle or multidisciplinary rounds at all three hospitals.

So far I have heard great things the way we are conducting these rounds. 

We have a huddle for 20 minutes every day, less than a minute per patient at a specific location in each hospital.

Out team members include everyone who are stakeholders in patient care.

1- Dedicated case manager. (I would appreciate if you can assign a dedicated case manager for all our patients)
2- House nursing supervisor.
3- Floor supervisors (optional).
4- Physical therapy and occupational therapy.
5- Dietary.
6. Core measure/ quality measure person for real time corrective measures for CHF, Pneumonia, AMI etc.
7- Hospital DRG coder. (Again this would take care of any def. in documentation).
8- Mr. Computer, so we can take care of orders during rounds.
9. Pharmacist (if they can).

Our team has so far improved,
1- Potential early discharges and transfers. 
2- Plan of care for the day.
3- Identify needs for patients.
4. Improve work flow and delegation of tasks.
5. Improve core measure compliance and power plans. 
6. Improve documentation. 
7- Contain cost per case.

And the best part is.... it is a lot of fun.